20 States With Highest & Lowest Medicaid Physician Pay Increases in 2013
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Written by
Bob Herman
| Thursday, 20 December 2012 15:11

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Primary care physicians who treat Medicaid patients in Rhode Island, New York, California, Michigan, New Jersey and Florida may be able to breathe a little easier next year, as their Medicaid pay rates are estimated to increase more than 100 percent, according to a report from The Kaiser Commission on Medicaid and the Uninsured (pdf).

Under the Patient Protection and Affordable Care Act, states will have the option to expand Medicaid coverage to more people. Because of this, the PPACA also included a rule that would increase Medicaid payments for certain primary care physicians to Medicare rates over the next two years, starting this January.

In November, CMS released a final rule indicating that all primary care physicians in specialties of family medicine, general internal medicine or pediatric medicine (and related subspecialties) will be paid Medicare rates for Medicaid primary care services for calendar years 2013 and 2014.

In the Kaiser Commission's report, analysts looked at which physicians would benefit the most from the final rule based on their state's Medicaid-to-Medicare fee ratio. For example, across the entire United States, Medicaid payments to primary care physicians are 58 percent of comparable Medicare payments.

Primary care physicians are paid the least for Medicaid services in Rhode Island, New York, California, Michigan, New Jersey and Florida. Physicians in Rhode Island are expected to see a 198 percent raise in Medicaid payments in 2013 — the most of any state.

Here are the states with the largest and smallest estimated Medicaid fee increases to primary care physicians in 2013, based on the Kaiser Commission's report.